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Stephen W. Porges: The Polyvagal Theory
Relational Implicit November 2011
Stephen W. Porges, Ph.D., is a professor of psychiatry and the director of the Brain-Body Center at
the University of Illinois at Chicago. He is a former president of the Society for Psychological
Research and also the Federation of Behavioral, Psychological, and Cognitive Sciences. He is a
former recipient of a National Institute of Mental Health Research Scientist Development Award. He
has published more than 200 peer-reviewed scientific papers across several disciplines including
anesthesiology, critical care medicine, ergonomics, exercise physiology, gerontology, neurology,
obstetrics, pediatrics, psychiatry, psychology, space medicine, and substance abuse. His research
has been cited in several thousand peer-reviewed articles and has been continuously funded by the
National Institutes of Health since 1975. In 1994 he proposed the Polyvagal Theory, a theory that
links the evolution of the vertebrate autonomic nervous system to the emergence of social
behavior. The Polyvagal Theory provides a theoretical perspective to study and to treat stress and
trauma.
Serge Prengel, LMHC is the editor the Relational Implicit project (http://relationalimplicit.com).
For better or worse, this transcript retains the spontaneous, spoken-language quality of the podcast conversation.
Serge Prengel: This is a conversation with Stephen Porges. Hi, Stephen.
Stephen Porges: Hi, Serge.
Serge Prengel: Based on your writings, it appears that you have paid a lot of attention to the nervous
system?
Stephen Porges: Yes, my research has focused on how neural regulation of physiological state
influences behavior and how these mechanisms are related to how we interact socially. In fact, even
when I was young I was curious about how we regulate our behavioral state in the presence of
others. Although the question originated in my youth, it has been only during the past decade or
two that I realized that this ability was a core issue in many aspects of mental health and had a great
impact on quality of life.
Serge Prengel: So it’s not just an individual pursuit of understanding how to regulate yourself.
Stephen Porges: Well, it actually may have started out as a personal pursuit and then somehow it
blended into my research question and co-opted my research skills. My research started off
addressing a more esoteric question related to the parameters of physiological reactions that would
enable efficient information processing. Then as I was developing my research skills, I started to
think about underlying physiological processes and not just physiological indicators or correlates of
efficient cognitive processes. I started to ask questions about bodily feelings and emotions.
Gradually, I started to ask questions about regulating bodily feelings and emotions in the presence
of others and started to investigate the interesting dialectic between how the nervous system
mediates our visceral feelings and how these feelings are easily mediated by social interactions.
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Serge Prengel: How does our nervous system interplay with our visceral feelings?
Stephen Porges: Although the important role that the nervous system plays in regulating our visceral
state and thus our feelings is a relevant question for people interested in body psychotherapy, it is
not even acknowledged in many of the models, theories, and therapies emphasized in clinical
psychology and psychiatry. Clinical psychology and psychiatry primarily use top-down models that
focus on emotions and affective processes as being central phenomena and minimize the role of the
body in the experience. For example, consistent with these models, even anxiety may be a “brain”
process without a visceral manifestation. Fortunately, there are clinicians, including many body
psychotherapists, who have an appreciation of the importance of the bidirectional communication
between the brain and the body. For example, sensory information travels from the body to the
brain and influences how we respond to the world. And brain processes can influence our viscera
via the cognitive and affective processes related to our perspective of the world and our reactions to
various features of the environment. This bidirectional and interactive notion of how our nervous
system regulates our viscera in a complex social environment, although intuitive, is neglected or
minimized by much of clinical medicine including psychiatry.
Serge Prengel: Feelings don’t happen by themselves in some kind of isolated sphere, but there is a bi-
directionality between our bodily feelings and cognitive thoughts.
Stephen Porges: Absolutely. The strategy of subjugating feelings and the preeminence of cognitive
processes follow a long tradition in Western culture of emphasizing thought at the expense of
feelings. For example, we can go back to Descartes and discuss how his philosophy structured mind-
body dualism. Descartes states in French, “Je pense, donc je suis”, and of course your French is
much better than mine but is, “I think, therefore I am.” He does not use the phrase, “Je me sense,
donc je suis.” I apologize for poor pronunciation. However, if Descartes used the reflexive form of
the verb “to feel,” he would have been emphasizing how the body is feeling, the visceral feelings
that parallel and contribute to our emotions and not how it feels to touch an object. Unfortunately
the personal experience of feelings within the body was not part of the equation for Descartes. But
imagine how our treatment of people would have evolved, if that’s what Descartes had really said.
Where would we be today, in terms of developmental trajectory of what it is to be a human?
Instead, based on Descartes, our culturally philosophy has adopted the premise that to be a good
human, we have to depress or reject or subjugate visceral feelings to enable our good brain, our
smart brain, to express its potential. Physical and mental illness may be a consequence of an
adherence to Descartes’ dictum. Thus, not respecting the body’s own responses and filtering
visceral feelings, over time may contribute to illness by dampening the bi-directional neural
feedback between brain and body.
Serge Prengel: It might be helpful to our listeners, to discuss how we experience visceral feelings and
they connect to our cognitions and what may happen if there are problems in either expressing
visceral feelings or if there is a disconnect between our cognitions and the rest of the body.
Stephen Porges: Well, it’s really quite interesting. I am actually writing about this now. I have been
working on the impact of safety on the access of various attributes of our nervous system.
Understanding the prerequisites for feeling safe is a critical issue in the modern world. Our culture
takes a paradoxical perspective in defining safety. We focus on words and cognitive representations
and minimize bodily responses and feelings to define safety. As professionals and academics we
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think that we can use our cognitive skills to define safety. Yet being “safe” is really the body’s
response to the environment.
Basically, educational and socialization processes are working very hard to dismiss the body’s
responses to environmental features. If we observe children in a classroom, we note a variety of
behavioral features that illustrate that some children are safe and can sit comfortably in the same
environment that triggers in other children the hypervigilant behaviors characterizing a lack safety.
Moreover, the children who are chronically monitoring the classroom for danger cues are the same
children who have difficulties in learning, while those with the features of feeling safe can attend to
the teacher and learn efficiently. Unfortunately, the traditional classroom model for education
assumes that if some children can perform well in a classroom, every child should. Thus, our
society treats the behaviors of individuals, who are behaviorally or viscerally reactive to slight
changes in stimulation, as bad. Society assumes that these children should be able to voluntarily
turn these behaviors off.
Rather than investigating and understanding that there is a neural substrate underlying the
observed range of individual differences, we basically convey to these children that the behaviors
are bad even if the behaviors are involuntary. Alternatively, the educational process could celebrate
some of the unique sensitivities that people have. However, this seldom occurs and leads into the
world trauma treatment in which many of our colleagues work.
In the world of trauma, people’s bodies respond. In some cases, the behavioral pattern and neural
regulation changes dramatically following trauma. These changes can be so great that the
behavioral features may appear to represent a totally different person, who no longer can relate to
others or interact in the same world. Since the behaviors of the traumatized individual do not
conform to the expectations of typical social interactions, the traumatized individual often feels that
they are inadequate or can do things correctly. These feelings of inadequacy may be driven by
societal expectations and even through the evaluative feedback during clinical sessions. For
example, therapeutic strategies may provide a continuous dialog of evaluation, often emphasizing
deficiencies in a hope of triggering voluntary control of more prosocial behaviors. However, the
continuous evaluation of their behavior may push the client further and further into defensive
strategies.
Serge Prengel: I want to slow it down a little bit, because there’s so much information in what you
are saying. For instance, children are exposed in school to a pre-imposed model that’s almost a
mechanical model of functioning. Children are treated like machines. If one machine functions a
certain way, then similar machines are expected to have the same behavior regardless of any
individual differences in physiological arousal or threshold to be reactive to environmental
stimulation.
Stephen Porges: Yes. In another way, even to re-emphasize what you very succinctly described, we
treat children in school as if they are learning machines and the success of school is really defined by
what information we are able to program into that machine. We don’t respect the fact that perhaps
the skill set of learning how to regulate your visceral state are not part of the curriculum. Thus,
opportunities to exercise neural systems to improve neural regulation of physiological state, which
in turn would support a more efficient expression of social behaviors, are not available or are
minimized in the prevalent educational models.
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These points become obvious when studying challenged individuals, like autistic children.
Interestingly, with autistic children, the basic treatment model is a special education model. This
model builds on learning theory and uses reinforcement and repetition in the establishment of skills.
Unfortunately, the “learning model” does not incorporate an important feature of autism, which is
shared with other clinical disorders, the inability to regulate visceral state in the presence of others.
In contrast, the prevalent treatment models force the individual to regulate in a context that may
make learning inefficient.
Serge Prengel: Yes. Sensitive and effective therapists are very careful to realize that clients cannot
change unless they’re in a regulated state. Unfortunately, treatment models often impose a less
sensitive model on children and try to force feed them when they haven’t learned the basic of
regulation.
Stephen Porges: In addition, the child’s nervous system might not be sufficiently developed to
regulate in a complex setting. So rather than incorporating an understanding of how the nervous
system regulates behavioral state, we try to use laws of learning by ramping up the motivation
through punishment or reward to change behavior when perhaps the neural mechanisms are not
sufficiently developed or atypical. Thus, these strategies are, at best, inefficient.
I like to illustrate this with a metaphor that I use in my talks. In my talks I often discuss underlying
visceral state as coloring our reaction to the world. I put a slide up of a traffic light with green,
yellow and red lights. Each light represents different physiological states. The green light represents
a physiological state associated with safety. The yellow light represents a physiological state
associated with danger. The red light represents a physiological state associated with life threat. To
the left of the traffic light signal an “S” for the environmental stimulus. To the right of the traffic
light I put an “R” for the individual’s response to the stimulus. Thus, the response to a common
stimulus is qualified by the physiological state. The same stimulus in the environment might
produce qualitatively different responses based on the physiological state of the individual at the
time the stimulus is presented.
Serge Prengel: Yes. So as you describe this interaction between cognitive processes, reactions and
the ability to regulate our emotions and our reaction to fear, it feels that you’re giving a great
example of what you said earlier about how that’s a different conception of what it’s like to be
human.
Stephen Porges: Yes. Basically I am questioning the goals of our institutions. Are the goals of our
institutions to educate people with more information or are our goals to make people be able to
reciprocally interact and to regulate each other to feel good. This goes back to Descartes’s dictum,
which has led us down a track of more thinking, expansive cognitive skills, and cognitively defined
“smarter people.” However, despite this enhanced level of smartness, we have become literally
ignorant about what our bodies really need to feel good.
Serge Prengel: Maybe we should talk about what our bodies need to feel good. Maybe we can talk a
little more about that the mechanisms of how visceral reactions work, how the defining features of
the neural circuits connecting the viscera and the nervous system. This is important, because often
people discuss being in their body and there is an almost a mystical or metaphysical quality to the
body versus thought. And as I think you described the process itself, there is a sense of that bottom-
up quality.
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Stephen Porges: I like to say that a goal of society is to be able to immobilize without fear. This
statement might initially sound strange. However, when you think about it, isn’t immobilization
without fear really a goal of therapy? You don’t want your clients to remain “tightly wrapped,”
anxious and defensive. You want your clients to be able to sit quietly, to be embraced without fear,
and to be hugged and to hug others, to conform physically when embraced, and to be reciprocal in
their relationships. If a client is tightly wrapped with a tense muscles and a highly activated
sympathetic nervous system state, the client is conveying this state of defensiveness to others. A
state characterized by tense muscles and sympathetic excitation is an adaptive state that prepares
an individual to move or fight. This state unambiguously conveys to others that it is not “safe” to be
in close proximity with this person.
This may be a good time to emphasize some of the neural circuits that regulate the autonomic
nervous system. The first point is related to the information flowing from our body to the brain. The
autonomic nervous system is extraordinarily important in conveying information about our viscera
to our brain. The vagus, the largest nerve in the autonomic nervous system and the major nerve of
the parasympathetic nervous system, is primarily a sensory nerve with about 80% of its fibers beings
sensory. The vagus is continuously conveying a tremendous amount of information about the status
of peripheral organs to specific nuclei in the brainstem. The sensory information from the visceral
does not share the same specificity as tactile stimulation other sensory information going up the
spinal cords. Visceral feelings are generally diffuse, so the actual labeling becomes difficult and the
diffuse feelings often “color” our perceptions and reactions to social interactions.
The second point is related to the motor control of the autonomic nervous system. In fact, the
traditional definition of the autonomic nervous system focused solely on the motor components,
the neural pathways in the periphery to the target organs, and the target organs in the viscera.
Important characteristics of the vagus have been neglected by this focus on the motor portion of the
vagus without examining the brainstem areas in which the vagal pathways originate. Specifically,
the fact that the vagus has two functionally distinct branches with different functions is often
neglected.
Most individuals are taught that the autonomic nervous system has two components, a sympathetic
nervous system associated with fight-flight behavior and a parasympathetic nervous system, which
is primarily associated with a cranial nerve known as the vagus, associated with growth, health and
restoration. This presentation of the autonomic nervous system suggests that the sympathetic and
parasympathetic components are antagonistic. While casting the autonomic nervous system as
reflecting paired antagonism is at times useful, it is not completely accurate. Thus, although we
often use the construct of autonomic balance, the autonomic nervous system seldom functions as a
balance system and is more likely to react to challenges in the environment in a hierarchical manner.
It is the contradiction between conceptualizing the components of the autonomic nervous system
either as a “balance” or “hierarchical” system that served to motivate me to develop the polyvagal
theory. In the traditional view of the autonomic nervous system, the sympathetic nervous system is
involved in fight and flight responses, while the parasympathetic nervous system is involved in
health, growth, and restoration. However, the polyvagal theory actually describes two defensive
systems. In addition to the defensive system of fight-flight, which everyone is familiar with, that
requires sympathetic and adrenal responses, the theory identifies a second defensive system. The
second system is linked not to mobilized fight-flight behaviors, but to immobilization, shutting
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down, fainting, and dissociating. This second defense system is a life threat system that is
frequently observed in small rodents such as mice.
When a cat picks up the mouse, the mouse immobilizes and looks dead. This is not a voluntary
behavior. The mouse is not deciding to play dead. Rather, the life threat features of the cat trigger
an ancient neural circuit that is frequently used by reptiles as a defense system. However, since
reptiles’ small brains do not need much oxygen, they can immobilize and even hold their breath for
long periods. However, this is not an option for mammals, which need massive amounts of oxygen
to support their larger brains. This shutdown immobilization response is mediated by vagal
mechanisms. In fact, fainting is called a vaso-vagal syncope, which acknowledges the potent
disruptive effect of the vagus on our normal cardiovascular function.
Thus, we have a vagal response pattern that is not consistent with health, growth, and restoration
metaphor that has been associated with the vagus and the parasympathetic nervous system for
decades. The vagal defense system has literally been written out of the literature on the autonomic
nervous system. Without a “vagal defense system,” autonomic function fits nicely into a simple
paired antagonism model in which the sympathetic component supports fight-flight behaviors and is
competing with the parasympathetic component that supports health, growth, and restoration.
The inclusion of the vagal defense system challenges this simple model of autonomic balance and
forces us to reconceptualize the adaptive reactions of the autonomic nervous system as reflecting
the three hierarchical components. The functional hierarchy mirrors the phylogeny of these
autonomic components in vertebrates. The oldest vagal system is mediated by an unmyelinated
vagus that originates in the dorsal motor nucleus of the vagus. This system is shared with virtually
all vertebrates. In mammals this system when triggered as a defense system inhibits breathing,
slows heart rate, and promotes defecation. However, in safe contexts, this system supports the
subdiaphragmatic organs to promote health, growth, and restoration. The sympathetic nervous
system when triggered as a defense system functionally inhibits the old vagus and stops digestion
and diverts energy resources from visceral support, such as digestion, to mobilization. The
phylogenetically most recent autonomic system is unique to mammals and represents a myelinated
vagus, which originates in a brainstem structure that is linked to the muscles of the face and head.
Now we understand that when people smile, when they are happy, and when their voice has
prosodic features reflected in variations in vocal intonation like a mother’s lullaby, they are able to
focus, to hear and to understand vocal communication. Functionally, the myelinated vagus is
calming us, efficiently processing our cardiovascular and metabolic needs, and actively inhibiting the
high states of arousal associated with the sympathetic nervous system. .
Serge Prengel: So the vagus or the two parts of the vagus nerve are in fact, on the one hand, the
most ancient and also the most recent parts of our evolution.
Stephen Porges: Yes. The two components of our vagus are mirroring the extreme features of
vertebrate evolution of the autonomic nervous system.
Serge Prengel: And the fight-flight is in between.
Stephen Porges: Yes with the sympathetic nervous system supporting fight-flight behaviors. I have
developed a simple narrative to describe the unique autonomic and behavioral features of
mammals. As mammals evolved, their survival was dependent on satisfying a need to interact for
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nursing and for other forms of social interactions and group behaviors linked to obtaining food,
reproducing, playing, and supporting general safety needs. The new mammalian vagus was able to
turn off defensive systems. However, to balance the needs of social interaction with the needs for
safety, it is necessary to know when to turn the defenses off and when to turn the defenses back on.
In our society this is a major issue. When do we turn off our defenses? When are we safe to be in
the arms of another? When are we safe to go to work? When are we safe to go to sleep? Clients
often have issues about not feeling safe with others. They have difficulties turning off their defense
systems. They can’t be hugged. They have sleeping disorders. They have gut disorders. All these
symptoms are features of the autonomic nervous system that can only occur when the newer
myelinated vagal system isn’t appropriately regulating the sympathetic and unmyelinated vagal
components of the autonomic nervous system.
Serge Prengel: So to effectively use our evolutionary heritage, our newest vagal circuit needs to
effectively regulate the older circuits.
Stephen Porges: Right. I’m starting to link vulnerabilities of humans, in terms of their health and
mental, physical and mental health, to specific neural structures that define the differences
between reptiles and mammals. During this transition a mylenated vagus evolved and the defense
strategies became more focused on fight-behaviors and the immobilization defense system was
minimized. It was minimized because immobilization is potentially lethal to mammals, who have a
very high oxygen need. Our common ancestor with more modern reptiles, such as snakes or lizards,
was a reptile similar to tortoise. The primary defensive system of the large tortoise is
immobilization.
When we inquire about the experiences of traumatized individuals, we learn that many of them
have experienced a profound and unexpected immobilization. By explaining the vagal defense
system and how the unmyelinated vagus supports an ancient defense system to life threat, we can
be very helpful in demystifying the responses that traumatized individuals experience. Providing
information that life threat has triggered a very ancient response circuit that may reorganize how
the autonomic nervous system regulates physiological state may help the client understand the
changes in their day-to-day functioning.
Serge Prengel: Yes. So we are really talking about the fact that, in a way, the stronger the stress, the
more we tend to regress to a very archaic form of survival.
Stephen Porges: Yes. Our physical context interacts with our physiological state to determine the
options we have to deal with stressors and challenges. We will flee or fight, if we have an
opportunity to escape or to defend ourselves. To support these adaptive mobilization strategies we
stimulate our sympathetic nervous system. But if we are locked in a room or being held down, we
have very few options. Under these difficult and extremely dangerous and often life threatening
conditions, we might reflexively faint or immobilize in terror and slip into a dissociative state. These
defensive behaviors are dependent on a phylogenetically older circuit.
As an example, on a CNN news segment a video illustrated a plane that was having great difficulty in
landing. The wings were unstable and tipping up and down. Although the situation looked
precarious, the plane landed safely. After the plane landed, a reporter went to interview the
passengers. I am sure that the reporter expected the passengers to say that the experience was very
scary and that they were ready to jump out of their skin. The reporter asked a woman how she felt
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during the landing. Her response was “Feel? I passed out.” Obviously not everyone passed out on
the flight. Some passengers did have an experience of terror and felt like jumping out of their skin.
For the woman who passed out, her nervous system interpreted an inability to fight or to flee as a
life threat and shut her down. Her response was neurophysiologically similar to the experience of
the mouse in the jaws of a cat. It is obvious that there is an adaptive function to a fear induced
immobilization response in which the individual is no longer conscious or in the “here and now.”
Although the trigger for fainting is associated with mild hypoxia due to massive drop in blood
pressure, the defense response strategy has adaptive features by raising pain thresholds so that if
you are going to be injured you will not feel the pain.
Serge Prengel: Yes.
Stephen Porges: And, if you survive, hopefully you’ll be fine or at least you will be alive. The real
issue related to understanding the “shutdown” response as an adaptive defense reaction is to
respect the responses that our body may automatically employ to protect us from pain and to save
our lives and not to be angry at our bodies.
Serge Prengel: Yes. So again we are coming back to, in a way, what it’s like to be human and to have
that embodied experience.
Stephen Porges: Right. The embodied experience is critical to humans, because being interactive
with others is critical for human survival. Throughout the entire human lifespan, humans are
dependent on others. Starting with birth, infants require nursing and caregiving. As we mature, the
interactions shift from safety and food to facilitating our physiological state, which we experience as
emotional and behavioral regulation through our social interactions with friends and loved ones.
The main point is that humans require interactions with others to develop and to optimize their
potential. Several biological disciplines discuss similar processes within the construct of “symbiotic
regulation.” I think we are now in a good position to use this construct from a biobehavioral
perspective to explain several aspects of how human social interactions facilitate neurobiological
processes. Through expanding this construct we can see how we reciprocally are sending cues to
each other’s nervous systems. Social interactions are characterized by continuously transmitting
cues of safety or danger and whether it is safe to be held in the arms of another or to retreat and
protect ourselves. I have used the term Neuroception to explain this dynamic and interactive
process. .
Serge Prengel: You have paid attention to that in terms of the mechanism of in which we have
evolved love and attachment.
Stephen Porges: Yes. HIV patients provide an interesting example to elaborate on this point. In
studying HIV patients, I have learned that often their caregivers feel unloved and frequently get
angry attending to the needs of the infected individual. Parents of autistic children often report the
same feelings and experiences. In both examples, although they often report feeling unloved, what
they really are expressing is that the HIV infected individual or the autistic child is not contingently
responding to with appropriate facial expressivity, eye gaze, and intonation in their voices. In both
cases, the individual being cared for is behaving in a machine-like manner and the caregivers feel
disengaged and emotionally disconnected. Functionally, their physiological responses betray them
and they feel insulted. Thus, an important aspect of therapy is to deal not solely with the patient,
but to also include the social context in which patient lives with a focus on the parent-child or
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caregiver-client dyad. This will insure that the parents or the caregivers will learn to understand
their own responses as a natural physiological response. Unfortunately, caregivers and parents
often attribute motivation to the disengaging behavior. This creates problems. Similar to the
frequent responses of teachers in schools, who become angry and aggressive when students
disengage by turning away, parents and caregivers often justify their angry and abusiveness to the
challenged child or individual.
Serge Prengel: Yes. Can we override our reflexive reactions?
Stephen Porges: We can attempt to override these reactions. However, this is very hard to do. In
some of the workshops that I have conducted, I have tried a simple experiential to illustrate this
point. I call the experiential the reluctant therapist. In the reluctant therapist, I create triads in
which workshop participants rotate through three roles: therapist, client, and observer. In the
experiential, the therapist is instructed to gaze avert and turn away while the client is talking. The
interesting point of the experiential is that the individual in the client role frequently gets very angry
at the therapist. This occurs even though the client knew that the therapist was role playing and
instructed to turn away and disengage. In the experiential, the observer is uninvolved and has the
responsibility to be objective and to report how the behavioral cues trigger massive behavioral and
state shifts. When the participants rotate through the three roles, the reactions are reliably
replicated. It’s really quite amazing how easily our body changes state when someone disengages or
engages with us.
Serge Prengel: Yes. That’s the powerful part. Even knowing it, even in a role-play situation, social
engagement has such a hold on us that we really cannot easily disengage from it.
Stephen Porges: Yes. It is quite amazing. In therapeutic settings, clinicians may deal with couples
with different “engagement” resources. For example, if one member of the couple has a trauma
history that may be manifested in state regulation issues and accompanied with gaze-averting and
turning away from the other during confrontations or even during more positive social interactions.
What is the partner’s response to this? Often their response is simply to get angry.
Serge Prengel: Yes. So as I am listening to you, there is something that feels very nice about
deconstructing the mechanisms of what happens in an interaction and the importance of helping
others not take these things personally, helping them to diminish the attribution of blame, helping
them reduce the layers of interpretation that are a block to people functioning effectively with
others.
Stephen Porges: Yes. I totally agree. I think we live in a world that attempts to attribute motivation
to every behavior and to place an evaluative dimension of good or bad on the behavior. I use the
term “moral veneer” as the feature in our society that pushes us to evaluate behavior as good or
bad and not to see the adaptive function of the behavior as regulating physiological and behavioral
state. Rather our culture imposes an interpretation of the behavior as being motivated and either
good or bad.
When I talk to clinicians, I used to use an example of an instance when a boss or chairman didn’t
look at the clinician. I wanted to elicit a visceral feeling of being marginalized. I had expected
interpretations ranging from the boss didn’t like them or that they were not important enough for
the boss to attend to them. I noticed that many in audience had blank faces and could not relate to
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what I was describing. Then I realized that most clinicians don’t work for anyone. They don’t work
for anyone because these disengagement behaviors, which they often interpret as evaluative, did
not make them feel good. However, my life has been in the academic world, a social environment
in which administrators and many colleagues tend not to have good social skills. However, the point
I am trying to make is that most of the behaviors that we label as social skills are not learned.
Rather, most of these behaviors appear to be more an emergent property of our biological state
than our “skills” in learning.
There are people who make good eye contact, are curious of the other, and have a broad range of
facial expressivity. These people are also reciprocal in their social interactions. To maintain this
reciprocity, they are literally throwing obvious and often subtle cues at each other. These cues have
the potential to make the other person feel safe. When the cues are effective, the other person
returns the cues through facial expressions and vocalizations. The face appears more alive, more
expressive, the intonation of the voice becomes more prosodic, and the physical distance between
the two people if often reduced as the physical space starts to approximate the reduced
psychological distance. I am sure that you have observed this within your clinical practices.
Serge Prengel: We do when we are in the middle of clinical practice. We really pay attention to it and
we are very aware of it, but of course as we react as human beings. We have just as much difficulty
as everybody else paying attention to it.
Stephen Porges: Yes. My personal test of these qualities has occurred as a father and a mentor for
my students. How do we react to our children or students when they start throwing cues at you? I
learned that have to step back and think about their physiological state. What if they haven’t eaten?
What if they haven’t slept? What if they have all these other things going on?” If events and
contexts compromise their ability to recruit the neural circuit that supports safety and social
interactions, the interaction is going to be very challenging. So the ability to be engaging, expressive
and understanding is going to be limited. We can generalize to our entire culture and identify
features that would interfere with access to the neural circuit supporting social engagement.
Remember that our culture is not structured to promote personal safety. It is a culture that
unambiguously states that we can’t work hard enough, be successful enough, you can’t accumulate
enough, and everything is vulnerable. So the culture is really telling us that we live in a dangerous
place and during dangerous times. I always wonder what would humanity be like if we were more
respectful of humanity’s need for safety.
Serge Prengel: Yes. So you’re saying is that, one is that question of what if we actually were paying
attention to safety, as opposed to accumulating, also judgment, in terms of being evaluated in terms
of accumulation but also what you are saying is that the way up, the shift out, is not so much an
intellectual shift or an emotional shift about simply paying attention to safety but is changing into a
different system, voluntarily fostering the ability to shift into the social engagement system.
Stephen Porges: Yes. Well, again, if we are smart and this is where science can be helpful, we can
start learning what are the features in the environment that functionally trigger our nervous system
into fight-flight or allow us to move into a state of safety and recruit the social engagement system
and what are the features in the environment trigger a behavioral shutdown, immobilization with
fear, and states of dissociation. Often background noises can trigger a physiological state of
mobilization and disrupt social interactions and feelings of safety. I have noticed that several clinical
offices are in buildings with disruptive sounds including the low frequency sounds of ventilation
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systems and the mechanicals of large buildings. These sounds can interfere with the client’s ability
to progress.
Serge Prengel: I mean, if you are in New York City.
Stephen Porges: Right. You might have heard on this phone call sounds of a train, it was the
elevated train or “L” as we call it in Chicago. The train was producing physical cues to our nervous
system to be basically vigilant and to anticipate potential danger. Often we are not aware of the
how our nervous system is bombarded with cues to be defensive. A neurobiologically “informed”
design of an environment for humans would make sure that we lived, worked, and played in
environments without these features. Removing these forms of stimulation reduce the demands on
our nervous system to be hypervigilant for predator or for danger. With these forms of stimulation
removed we could more easily functionally relax, engage, and get all the benefits of a social
interaction.
Serge Prengel: Yes. Removing, paying attention to all of these things that put us in a hypervigilant
mode.
Stephen Porges: Yes. Safe environments are important for everything we do and especially for
therapies. I started to think about mindfulness meditation and realized that even mindfulness
meditation exercises need to be conducted in a safe environment. It becomes obvious when you ask
questions about how breathing and attention are influenced by background sounds and how easily
we can become distracted and hypervigilant. I also realized that recruiting the defensive systems
associated with sympathetic nervous system activation was incompatible with mindfulness.
Perhaps, a simple way of understanding this point is to realize mindfulness requires a state that is
non-judgmental. However, this would be incompatible with states of defense in which evaluation is
critical for survival. We can map this onto the polyvagal theory, evaluation is really the same thing
as saying, we are in a dangerous environment and thus we need to sacrifice social engagement
behaviors to insure that we are hypervigilant and poised for fight and flight behaviors.
Serge Prengel: Scanning the environment for danger. Paying attention to where to run.
Stephen Porges: Yes. When we encourage our children to study and to attend to computer
monitors, we are basically recruiting a hypervigilant state that is slightly modified to provide a state
of focused sustained attention. However, this is not a state that supports health, growth, and
restoration nor does it support the social engagement behaviors necessary for successful social
interactions.
Serge Prengel: Yes. So we are coming back to that sense of safety for the kids but for the grown up,
for everybody as you mentioned, the sense that it doesn’t make sense to really think about
mindfulness or pursue mindfulness per se without really actually paying attention to how we tend to
be reacting to a lack of safety so the awareness of what it is that makes us feel unsafe, the
awareness of facing it, dealing with it, is really a prerequisite for finding mindfulness.
Stephen Porges: Right. And the flipside is to understand the prerequisite features that enable us to
feel safe and to turn off defensiveness. This leads to the exciting future of clinical treatments. If we
were more understanding of the features in the environment that are capable of the turning off the
defensive systems, then clinical practices or clinical treatments would be more efficient. If the
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environment we lived in had the triggers for defense removed and replaced with features that
trigger safety, then life would be healthier and of a higher quality. Several features could relatively
easily be improved in our work and living environments. These would include reducing low
frequency noises in the environment, reducing the unpredictability of environment, and simply
being in proximity to people with whom you feel safe.
Serge Prengel: So, in a way, evolving toward treating underlying causes, as opposed to treating
symptoms.
Stephen Porges: Yes. We have different neural circuits that evolved with different but still
profoundly important adaptive functions. As these neurophysiological systems evolved they
provided neural platforms for emergent behaviors with each behavior having an adaptive function.
Thus, I do not like to conceptualize behaviors as good or bad, but view each behavior as sitting on a
neural platform that represents the organism attempt to adaptively survive. However, although this
model enables behaviors to be conceptualized as adaptive, some behaviors interfere with
appropriate social behavior and social interactions. Thus, a goal of therapy would be to enable
clients to regulate their visceral state and to engage and to enjoy the interactions with others. These
social behaviors require that newest neural circuit regulating the autonomic nervous system. The
neural circuit is unique to mammals and is only available when we feel safe. It is this system that
not only facilitates social interaction and enables social interaction to foster growth, health and
restoration, but it also has the capacity to down-regulate our reactions and the neural circuits that
evolved for defense.
Serge Prengel: So we no longer are talking in terms of traditional pathologies but we are talking
about things that have, in a way, are good reactions to possibly bad perceptions or basically
regulating the way we function.
Stephen Porges: Yes. I tend not to use the word, perception, because that involves a degree of
awareness and cognition. We respond to features in our environment with physiological shifts that
are outside the realm of awareness. I call this process Neuroception to emphasize that the process
is on a neural basis. Our body functions very much like a polygraph. Our body is continuously
responding to people and places. We need to learn more about how to read our body’s responses.
We have to know that when we feel uncomfortable, there’s a reason our body is feeling
uncomfortable and we need to adapt and adjust to that.
Serge Prengel: Except… To play devil’s advocate, I would argue with the sense of reading the
information because there, again, would be a cognitive process.
Stephen Porges: You are absolutely right. It’s a conundrum, isn’t it?
Serge Prengel: Yes. It’s hard to talk about processes without having these images.
Stephen Porges: Yes. I think we can wiggle out of this problem by merely saying that we need to
respect our body’s reactions and rather than continuingly try to develop the skill set that rejects
whatever our body is telling us. When we respect our body’s reactions, we can use our awareness
and our voluntary behavior to navigate into places where we would feel more comfortable. With
this new understanding we can create a partnership between our respect for bodily feelings with
our stewardship of the body via cognitive functions.
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Serge Prengel: Yes. I mean, that language for me, as I hear you, evokes a visual, gentle ways of, as
opposed to jagged movement.
Stephen Porges: Yes. When are young, we could deal with noisy places like bars or crowded rooms.
But as we mature we have difficulties understanding voices and relating to people when we are in
noisy and crowded places. In a sense our nervous system functionally starts to fail us. We want to
escape from these uncomfortable environments. Many people have similar experiences. However,
many people who have these experiences do not, in a sense, respect the uncomfortable bodily
reactions until it’s too late and they can no longer control their behavior.
Serge Prengel: Yes. So, in a way, a lot of our pathologies come from too great an ability to override
those signals.
Stephen Porges: Yes. We get the signals, but we do not respect them. I think this strategy of denying
our bodily reactions has much to with our culture. This point is related to my introductory comment
on Descartes, which emphasized a subjugation of bodily feelings to cognitive functions. Our culture’s
interdependence on religious views has contributed to dispelling the importance of bodily feelings.
Specifically bodily feelings were conceptualized as being associated with animals, while cognitions
were an attribution more closely linked to spirit.
Serge Prengel: Yes. So we get to that sense of conceiving who we are from a bottom-up perspective.
Stephen Porges: Yes. But it is really both a bottom-up and a top-down model. We want to maintain
the bidirectionality of mind/brain and the body/viscera connection, because our brain is regulating
our viscera and the viscera is continuously providing information to the brain. Simple movements,
such as shifts in posture, result in changes in the signals our brain receive. When we lean forward or
backward we change our blood pressure and send different information to the baroreceptors,
receptors that monitor blood pressure and communicate with areas in the brain. When we lean
back, we tend to become more relaxed and less aware of our environment. If we move to an upright
position, we trigger a change in blood pressure that makes us feel more alert and focused. Thus,
these simple behavioral manipulations which trigger blood pressure receptors can functionally
change our interactions with the world.
In our basement, we have a chair that reclines and takes all the pressure off the lumbar region.
When I in this chair I don’t want to get out of it. I feel totally relaxed and I don’t want to do any
work or think. I just want to be there. But when I go up to my office and sit in my desk, I am in the
upright posture. My motivations and outlook change. When sitting at my desk I start to see work as
interesting and enjoyable. It is as if the shift in posture results in two different interactions with the
environment. It is as if the psychological experiences reflect two different personalities: one
lethargic and the other engaged and enthusiastic. So something as simple as a slight shift in posture
can by triggering neurophysiological circuits change how we react to the world, how we organize
thoughts, and how we motivate ourselves.
Serge Prengel: Yes. And what’s interesting here is that this is caused by a shift in posture, which may
also cause a shift in the dyad between say, me and the environment.
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Stephen Porges: Actually, you are onto something and another way of viewing it is, you shifting from
being focused on regulating the smooth muscles of our viscera in the relaxed state to recruiting
striated muscles of our trunk and limbs in a more alert state. This occurs because sitting upright
requires an increase in muscle tone. To accomplish this task you need to recruit different neural
circuits than when you are reclining and the tone of your striated muscles are relaxed. In the recline
position, you become literally a smooth muscle organism, which has an agenda to conserve
resources. But, when you are in the upright posture, your skeletal muscles are required to maintain
muscle tone and you can now become an interactive, engaging organism.
Serge Prengel: So in a philosophical way, you think of the individual, the self as a process and under
certain circumstances, the process becomes oriented toward maintaining smooth muscles and
fostering a state of relaxation.
Stephen Porges: Yes. When you experience a relaxed immobilized state, specific physiological
processes may occur that would support health, growth and restoration. This is a very important
and useful state, although it does not support social interactions or expansive thinking.
Serge Prengel: Yes. So we’re, in a way, just talking about the way in which we can be employ
different neural circuits that enable us to react to and adapt to the dynamic changes in the
environment. Go ahead.
Stephen Porges: If we conceptualize different neural platforms that support different domains of
behavior, we can start to interpret the behaviors and the limitations of behaviors within different
neural platforms as emergent behaviors. So when I am reclining, it’s not that my lack of social
behavior is maladaptive, but it would be viewed as being maladaptive if I had a group of friends over
for the evening. So the context is really defining what is appropriately adaptive. But the behaviors
are emergent properties of the neural platform and the adaptive characteristics are dependent on
the appropriateness of these behaviors within a specific context. Conceptualizing behavior in these
terms may change our understanding of behavioral pathologies. We might end up interpreting a
behavioral pathology as a behavior which might have been adaptive in one setting that is now being
elicited in a setting where it is maladaptive. For example, trauma victims, who maybe dissociating or
shutting down, may be expressing a reaction that would be adaptive during the traumatic event, but
is maladaptive in a social setting.
Serge Prengel: Yes. So a sense you are changing the definition of pathology to whether or not a
behavior is adaptive in the current context..
Stephen Porges: Yes. I totally agree with that and I think once we do that, behavior is neither good
nor bad. It is just behavior that doesn’t fit the context. This will enable us to take away some of the
moral labels that have affected people who have difficulties regulating state to access the neural
platforms that would support more appropriate behaviors. .
Serge Prengel: Yes. And it’s in a context of, definitely very, very important, very powerful in taking
away that stigma, taking away the judgment, taking away the moral context and judgment
evaluation in a way that puts us in a mode of danger.
Stephen Porges: Defense.
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Serge Prengel: Defense. And yes and in contrast. Sorry, go ahead
Stephen Porges: I was going to say, you are really getting the core of the theory and how the theory
can be distilled into very simple constructs related to our quest for safety. If we are not safe we are
chronically in a state of evaluation and defensiveness. However, if we can engage the circuits that
support social engagement, we can regulate the neural platform that enables social engagement
behaviors to spontaneously emerge. From a Polyvagal perspective, this is the objective of therapy.
Serge Prengel: And in contrast, this is a view that is about, just understanding that these are
processes that have a certain, apparent flow, and re-directing, learning, just in a way working with
that potential that we have to learn and adapt.
Stephen Porges: Well, you brought up another important point, which I should discuss before we
close. That is, even though we have those three circuits to regulate state, we can modify the two
defensive circuits through the use of this newer mammalian, social engagement system that is
available when we are safe. Thus, once we can easily engage the social engagement system, we are
free to mobilize without being in fight or flight. Rather than fight or flight, we can move and play.
Although fight/flight and play behaviors both require mobilization, play turns off defensiveness by
maintaining face to face social referencing. Play uses the social engagement system to signal that
the intentionality of the movements is not dangerous or hurtful. You can see this when dogs play.
They chase each other and may mildly bite the other, and then they make face to face contact and
role reverse. If we watch people when they play sports, if they hit someone while playing they will
diffuse the aggressive reaction by making good eye contact and social communication. However, if
they hit someone accidentally and walk away with defusing the valence of the action, a fight might
occur. Similarly, the immobilization circuit may also be co-opted by the social engagement circuit
during loving behavior that may initially start with face to face interactions that are followed by an
immobilized state without fear. Over time we become able to immobilize in the arms of another. I
keep emphasizing the important role of immobilization without fear, because for mammals,
immobilization is potentially lethal. So mammals are always moving, unless they can feel safe with
another.
Serge Prengel: Are we talking about the good immobilization?
Stephen Porges: Yes. The “good” immobilization response, immobilization without fear, requires the
co-opting of the neural pathways involved in “immobilization with fear” with neuropeptides, such as
oxytocin. Functionally oxytocin has receptors in the brainstem dorsal motor nucleus of the vagus
that regulates the phylogenetically older unmyelinated vagus. This system of immobilization
without fear enables women to give birth without fainting or dying. The same “good”
immobilization system enables people to cuddle and hug without problems and enables women to
breast-feed without having to move. Thus phylogenetically older structures, which initially evolved
for defense, have been co-opted for play behaviors and for reproductive and sexual behaviors.
Serge Prengel: Great. So that’s a nice way, that’s a context in which we have, in that large context,
what we do in therapy is in a way part of that, is continuing that ability to adapt to structures.
Stephen Porges: Yes, to enable clients to experience greater flexibility in the world by having access
to neural circuits that can efficiently dampen defense in appropriate settings and to utilize the
phylogenetically older defense circuits for very positive outcomes.
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Serge Prengel: Yes. Thanks, Steve.
- This conversation was transcribed by San Kim.
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